Company Protocol Flashcards
(36 cards)
1
Q
Assessment: dyspnea a/o cyanosis diaphoresis erect posture distended neck veins bilateral rales tachycardia H of CHF
A
Suspect acute pulmonary edema
2
Q
Assessment: dyspnea bilateral wheezes urticaria gen. erythemia H of sting or ingestion
A
Suspect anaphylactic shock
3
Q
Assessment: tachy/brady dysrhythmia, acute MI, blunt chest trauma distended neck veins rales/rhonchi peripheral edema
A
Suspect cardiogenic shock
Consider tension pneumothorax
Consider cardiac tamponade
4
Q
Assessment: confusion severe headaches speech disturbances visual disturbances effected coordination staggered gate hemiparesis or hemiplegia unconscious a/o UR
A
Suspect cerebrovascular accident
5
Q
Assessment: altered CNS tachycardia/thready pulse kussmaul breathing hypotension dry mucous membranes cool skin fruity odor abdominal pain nausea vomiting polyuria polydipsia polyphagia
A
Suspect hyperglycemia
6
Q
Assessment: headache blurred vision dizziness weakness elevated blood pressure nose bleeds dyspnea peripheral edema pulmonary edema
A
Suspect hypertensive crisis
7
Q
Assessment: febrile hot dry skin hypotensive H of exposure H of exertion
A
Suspect hyperthermia
8
Q
Assessment: confusion agitation headaches comatose normal or tachycardic shallow, slow R diaphoresis cool skin flaccid muscle tone Grand mal seizure incontinence
A
Suspect hypoglycemia
9
Q
Assessment: altered LoC bradycardia hypotension temp
A
Suspect hypothermia
10
Q
Assessment: blood loss dehydration HR >120 BP
A
Suspect hypovolemic shock
11
Q
Assessment:
spinal injury or overdose
S of hypovolemic shock w/o peripheral vasoconstriction
A
Suspect neurogenic shock
12
Q
Assessment:
slight R rate increase
mild wheezes
good skin color
A
Suspect mild respiratory distress
13
Q
Assessment:
marked R rate increase
noticeable wheezes
accessory muscle use
A
Suspect moderate respiratory distress
14
Q
Assessment:
R rate >twice of normal
loud wheezes or no wheezes
Pt anxious, ashen skin
A
Suspect severe respiratory distress
15
Q
Assessment: cool, clammy skin febrile tachycardia/hypotension H of infection
A
Suspect septic shock
16
Q
Assessment: substernal oppressive pain nausea a/o vomiting dyspnea diaphoresis palpitations H of CAD H of CHF cardiac medication use syncope tachycardia bradycardia
A
Suspect symptomatic/ asymptomatic chest pain
17
Q
Assessment: acute respiratory distress or cyanosis w/ MoI and increasing distress cyanosis decreased/absent breath sounds unilaterally hyper-resonance of chest unilateral distended neck veins subcutaneous emphysema hypotension/cardiac arrhytmia (late) tracheal deviation (late)
A
Suspect tension pneumothorax
18
Q
Assessment: substernal oppressive pain nausea a/o vomiting dyspnea diaphoresis palpitations H of CAD H of CHF cardiac medication use syncope tachycardia bradycardia
A
Suspect STEMI
19
Q
Assessment: no pneumothorax Pt alert, cooperative patent airway R rate >25 Sys BP of 90 mmHg accessory muscle use
A
Consider CPAP
20
Q
Treat acute pulmonary edema
A
POC, O2, Heart Mon + VS, IV + lock
- Nitro 0.4 mg SL PRN x 3 Q 5 minutes (hold if hypotensive)
- Lasix 40-80mg IV over 2-3 min (1mg/kg in severe)
- Morphine Sulfate up to 10 mg IV slow titrated to BP + R
- Consider intubation
- Dopamine titrate to pt BP if hypotensive
- Contact MedCon
21
Q
Treat anaphylactic shock
A
- O2 100% + consider airway support
- Epi. 1:1,000 0.3mg SQ
- IV LacRing L bore - monitor hypotension
- Benadryl 50mg IVP
- Decadron 4mg IVP
- Contact MedCon (consider Epi 1:10,000 IV in severe)
22
Q
Treat cardiogenic shock
A
- Semi-fowlers or POC
- O2 100% + consider airway support
- IV NACL L bore
- Fluid challenge 500mL if low BP
- Consider Dopamine 2-20 mcg/kg/min on infusion pump (or dial-a-flow if NA)
- Contact MedCon
23
Q
Treat cerebrovascular accident
A
O2, consider intubation, heart mon + VS, IV + lock
- Check sugar, admin D50 + recheck
- Narcan 2mg IVP if narcotics suspect
- Keep head elevated
- Maintain body heat
- Anticipate seizures- treat w/ Valium up to 10mg IV Slow
- Doc stroke scale outcomes to det stroke status
- Contact MedCon
24
Q
Treat drug ingestion- pt CONSCIOUS, patent, and substance NOT acid/alkali/petroleum base
A
- Protect self from exposure/unruly pt
- O2
- IV + lock
- Narcan 2mg titrated to effect if narcotics suspected
- Valium IV slow up to 10mg if pt convulses
A. If conscious, patent, and NOT acid/alkali/petroleum:
- Insert NG tube + lavage 1000mL H2O
- Actidose 50g via NG tube
25
Treat external chemical exposure
1. Protect self from exposure
2. ID subs + verify MSDS when possible
3. Notify proper agencies of location of spill + truck #s
4. Contact MedCon/PsnCon
1. Protect self from exposure
2. Remove pt from source + clothing
3. Decontaminate as directed by MedCon/PsnCon
26
Treat chemical exposure-inhalation
1. Protect self from exposure
2. ID subs + verify MSDS when possible
3. Notify proper agencies of location of spill + truck #s
4. Contact MedCon/PsnCon
1. Protect self from exposure
2. Remove pt from source (consider "C" haz mat suits + hood)
3. O2 100%
4. Treat SS as present
Contact MedCon/PsnCon
27
Treat drug ingestion- pt UNconscious, or substance IS acid/alkali/petroleum base
1. Protect self from exposure/unruly pt
2. O2
3. IV + lock
4. Narcan 2mg titrated to effect if narcotics suspected
5. Valium IV slow up to 10mg if pt convulses
B. If unconscious or IS acid/alkali/petroleum base:
1. ABC's, IV + lock, heart mon
4. Insert NG tube + lavage 1000 mL H2O
5. Actidose 50g via NG tube
6. Contact MedCon
28
Treat hyperglycemia
1. O2
2. IV NACL KVO (consider fluid bolus if hypotensive)
3. If sugar >250mg/dL, increase IV rate to 200 mL/hr and heart mon
4. Contact MedCon
29
Treat hypertensive crisis
1. O2
2. Elevate pt head
3. Heart mon
4. IV + lock
5. Consider nitroglycerin 0.4 mg SL (do not rapidly drop BP)
6. Contact MedCon
30
Treat hyperthermia
1. O2
2. Remove clothing + cover w/ tepid H2O, esp forearms
3. Expose circulating air
4. Consider cold packs behind neck + under arms
5. IV LacRing KVO + heart mon
6. Consider fluid bolus if pt tachycardic or hypotensive
7. Contact MedCon
31
Treat hypoglycemia
1. Monitor VS
2. Heart mon if comatose
3. O2
4. IV + lock
5. Check sugar
If
32
Treat hypothermia- unconscious + pulseless (evaluate one full minute)
1. Handle gently- no triggering V-Fib
2. Remove wet clothing; dry + cover
3. Warm humidified O2
Unconscious + Pulseless
4. CPR & O2, intubate as needed
5. DO NOT CPR if bradycardic rhythm on monitor
6. Contact MedCon
33
Treat hypothermia- fibrillating + core temp
1. Handle gently- no triggering V-Fib
2. Remove wet clothing; dry + cover
3. Warm humidified O2
Fibrillating +
34
Treat hypothermia- fibrillating + core temp >85F
1. Handle gently- no triggering V-Fib
2. Remove wet clothing; dry + cover
3. Warm humidified O2
Fibrillating + >85F
4. V-Fib protocol
5. Contact MedCon
35
Treat hypothermia- transport time >15 min
1. Handle gently- no triggering V-Fib
2. Remove wet clothing; dry + cover
3. Warm humidified O2
Transport time >15min
4. Add heat via warm external objects to head, neck, chest, + groin
5. Do not warm extremities
6. Contact MedCon
36
Treat hypovolemic shock
1. O2
2. Control bleeding
3. Two large bore IV's (blood set for one if possible)
4. Heart mon + VS
5. Keep warm + cover
6. Contact MedCon
